Response to Request for Information

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Response to Request for Information

Meaningful Use EHR Vendors

Prepared For:

eHealthConnecticut

August 18, 2010

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McKesson Terms

By opening this proposal package and reviewing the confidential materials included,

eHealthConnecticut is agreeing to the following terms:

All information contained in this document and all information provided by McKesson

Technologies Inc. and its affiliates (McKesson) shall be strictly protected by eHealthConnecticut,

and eHealthConnecticut agrees not to disclose any information without legal requirement or

previous written consent by McKesson. Further, all McKesson information shall be used by

eHealthConnecticut only for the purpose of evaluating the potential for entering into a

contractual relationship between McKesson and eHealthConnecticut. All rights, title and interest

in and to the confidential information shall remain the property of McKesson.

McKesson has answered the questions put forth by eHealthConnecticut to the best of its ability

as of the date of this response. Software and hardware prices quoted are valid for ninety (90)

and sixty (60) days, respectively, from the date of this document.

It is McKesson’s policy not to accept or decline contractual requirements in Proposal documents.

McKesson’s legal staff will evaluate each requirement during contract negotiations and will

make every effort to develop mutually agreeable terms with eHealthConnecticut. Should

eHealthConnecticut request inclusion of this proposal response (or any portion hereof) in any

contract, McKesson reserves the right to audit such proposal response and include only those

portions of the response which relate to the features/functionality of the purchased software.

Should any of the requirements on the pages of this proposal response contain responses with

McKesson’s standard contractual language, these responses should in no way bind McKesson to

any contractual requirements prior to negotiations. Notwithstanding anything else in this RFP,

McKesson will agree to the Terms and Conditions of the Request for Information only to the

extent that they are not additional to or in conflict with the terms and conditions of McKesson’s

contracting document. McKesson will also agree to entertain negotiations on those terms

additional to and/or in conflict with the contracting document.

Copyright © 2010 McKesson Corporation and/or one of its subsidiaries. All product and service

names listed herein are protected by registered trademarks, service marks, or non-registered

trademarks of their respective companies. All rights reserved.

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McKesson Provider Technologies 5995 Windward Parkway Alpharetta, GA 30005 404.338.6000 Tel 404.338.6101 Fax August 16, 2010 eHealthConnecticut 1111 Cromwell Ave, bldg 201 Rocky Hill, CT 06067

Dear eHealthConnecticut Team,

Congratulations on your selection as a Regional Extension Center and thank you for providing McKesson with the opportunity to be considered by eHealthConnecticut as one of your sponsored EHR vendors. We truly appreciate your interest in McKesson, and are looking forward to the opportunity to work together to build a mutually beneficial partnership in Connecticut.

McKesson has created an organization focused solely on Regional Extension Center partnerships and we have made it known to our potential partners that we see this initiative going well beyond just EHR selection and implementation. As confident as we are in our EHR solutions, we are equally as mindful to the fact that this is a long-term agreement between two organizations that share the same ultimate goal of furthering successful and meaningful physician IT adoption both in Connecticut and nationwide. Whether it is assisting you with provider access, the design and deployment of your REC service catalogue, or assistance in the structuring of your organization’s long term sustainability model, we have the resources to help you in reaching your goals.

You may not be aware that more than 100,000 small physician practices across the country depend on McKesson software solutions today to run their practice. We have created that reach by working with a national network of over 200 Value-Added Reseller partners who serve as an extension of the McKesson team. We have discovered the secret to what makes partnerships work and are proud of this unique core competency.

McKesson would like to partner with your organization and share our building blocks for success. Currently, over 600 practices in Connecticut are running our solutions for independent physicians, including Practice Partner, Medisoft and Lytec. Some of those practices are serviced directly by McKesson and others are served by the 3 Value-Added Resellers that reside in Connecticut. We also have 10 McKesson representatives in Connecticut calling on Primary Care Physicians. As you can see, McKesson is well positioned to help you reach and service the physicians in Connecticut.

Lastly, McKesson offers a number of ways to address the affordability of EHR for your practices. From our complete Implementation of Medisoft Clinical for less than $4,500 to our 12-month, 0% interest promotion, McKesson is focused on maximizing value and minimizing disruption for the small primary care provider. When appropriate, we would like to discuss these options with eHealthConnecticut.

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8/18/2010 Page 2

Please find our responses to the RFI attached and please note that our response represents three clinical product lines we currently offer; Practice Partner, Medisoft Clinical and Lytec MD. All three solutions are based upon the same EHR, all Solutions are CCHIT Certified, but have different branding and practice management systems. We are very excited about the opportunity to develop and enhance a long-term, mutually beneficial partnership with eHealthConnecticut. Please do not hesitate to contact me with any questions or needs for clarification.

Sincerely,

Derek W. Schoonover VP Government and Strategy McKesson Corporation 770 881-3966

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Executive Summary

Request for Information Response

Pricing Matrix

Attachments

Attachm

A. Sample Implementation Plan

Attachm

B. System Requirements

Attachm

C. Product Literature

Attachm

D. Case Studies

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Executive Summary

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Top 10 Reasons to work with McKesson as Your

Strategic Partner

The Best Choice for your

Regional Extension

Center

“We were not only looking

for a good system, but also

for a good company that

was responsive to its

customers.”

- Mike Maxwell, M.D. Family Medicine of Port Angeles

“I wanted a fully integrated

software system that would

allow my practice to

operate as efficiently as

possible.

McKesson’s EHR system

has succeeded in this

objective.”

- Alan Falkoff, M.D.

High Ridge Family Practice

With countless electronic health record (EHR) vendors vying for your

attention, we know it’s getting awfully loud out there. To help tune out

the noise, we’ve outlined what to look for in a company and product —

and why McKesson is the best choice for your Regional Extension

Center. Simply put, we’ve helped thousands of physicians increase

productivity and enhance quality of care. We can help you do the same

for the physicians in your community.

Here’s how:

1. Experienced, Established, Proven Healthcare Company

McKesson, currently ranked 14th on the FORTUNE 500, is a healthcare

services and information technology company that has been in

continuous operation for more than 175 years, focused on delivering

solutions to primary care physicians for over 35 years. We are

committed to providing a certified EHR solution that will enable

physicians to achieve meaningful use as evidenced by our track record

of CCHIT-certification every year since the inception of the certification

process.

2. Reach to Physicians in your Community

McKesson solutions are used by more than 100,000 providers across

the country. We offer these solutions directly or through a national

network of locally based EHR-certified, Value Added Resellers that

deliver training, implementation and support services to physicians in

your communities. McKesson also delivers technology solutions to over

50% of the hospitals and 77% of the hospitals over 200 beds throughout

the US. A number of these hospitals are already partnering with

McKesson to connect the physicians in their communities using our

solutions.

3. A Track Record in Supporting Partners

McKesson has years of experience supporting partners that resell and

service our solutions in their local communities. Today we have over

200 EHR-certified Value Added Resellers across the country. We have

the required infrastructure in place to support partners in a variety of

ways including dedicated partner support, education programs on our

EHR solutions and implementation methodology, a marketing portal that

provides a variety of customizable tools to use with physicians, and

much more.

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A Better Way to Practice

Advanzed Health Care Arlington, Va.

Two physicians

– Increased average daily visits by 10%

– Increased annual revenue by $40,000 without

additional staff – Made measurable

improvements in patient care:

- Coronary heart disease patients on a

lipid-lowering prescription rose from 58% to 95%

- Diabetes patients undergoing the

microalbumin/creatinine test to evaluate kidney function rose from 4% to 85%

Cookeville Primary Care Associates

Cookeville, Tenn. Two physicians

– Hyperlipidemia patients using anti-platelet therapy rose from 32% to 58% – Coronary heart disease and

stroke patients with their most recent LDL< 100 mg rose from 57% to 71% – Atherosclerotic patients

with an LDL measurement in the past year rose from 56% to 75%

– Adult diabetic patients who had a pneumococcal immunization is 80% compared to the national average of 20%

4. Suite of EHR Solutions featuring Bright Note Technology™

McKesson offers a broad range of EHR and practice management

solutions including award-winning Practice Partner®, Lytec® MD and

Medisoft® Clinical. Our solutions feature Bright Note Technology which

instantly populates all critical data on a patient chart. This dynamic

processing technology enables physicians to use their preferred

charting style to capture data in a single note and, with one touch,

synchronize searchable data across the complete chart.

5. Focus on Quality of Care

McKesson delivers a unique and pioneering concept in practice-based

quality improvement and research. Formed in partnership with the

Medical University of South Carolina, PPRNet is a practice-based

quality improvement and research network that offers quarterly,

practice-specific reports that measure clinical performance against

parameters in key quality measures.

6. Platform to Connect Physicians to the Outside World

RelayHealth, a McKesson company, delivers an interoperability platform

integrated with our EHR solutions for physician practices to securely

exchange information with other practices, patients, hospitals,

pharmacies, labs, payors and other stakeholders. This increased

visibility to patient information across care settings enhances patient

safety and is a requirement for meeting “meaningful use” criteria under

the American Recovery and Reinvestment Act (ARRA). Our solutions

provide the foundation for coordinated care for the communities in your

region.

7. Home to a Positive, Collaborative, Thriving User Community

Physicians will join an active community of users who share tips, tricks,

ideas, and experiences; a 3,000 member online forum; online template

and content sharing; and active customer advisory committees.

8. Unmatched Third-Party Validation – Year after Year

- ”Dragon Certified EHR” for Nuance’s Dragon Medical Speech

Recognition

- Best EHR and Practice Management System — AC Group

2004-2009 (6th consecutive year)

- American Academy of Family Physicians (AAFP) Survey — High

rankings in overall satisfaction, ease of use and functionality,

quality of care (2008, 2009)

- Selected to participate in the American College of Physicians

(ACP) EHR Partners Program (2008, 2009)

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9. An Industry Leader – Active in the Following Organizations

- eHealth Initiative Leadership Council

- Electronic Health Records Vendor Association

- Certification Commission for Healthcare Information Technology

(CCHIT)

- HL7 (EHR Standards)

- DOQ - IT Project

10. Affordable Pricing

McKesson offers straightforward, transparent and affordable pricing with

flexible financing options.

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Request for Information Response

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VENDOR PROFILE

Name

McKesson Provider Technologies

Any Previous Names

N/A

Address (Headquarters)

5995 Windward Parkway

Alpharetta, GA 30005

Main Telephone Number

(404) 338-6000

Website

Corporate Status (Publicly Traded,

Privately Held, For Profit, Not for

Profit)

McKesson Corporation is a publicly traded company on the New York Stock Exchange under the trademark symbol, "MCK."

PARENT COMPANY

Name

McKesson Corporation

Address

One Post Street

San Francisco, CA 94104

Telephone Number

(415) 983-8300

CONTACT PERSON

Name

Derek Schoonover

Title

Vice President, Government and Strategic Sales

Address

5995 Windward Parkway

Alpharetta, GA 30005

Telephone Number

(770) 881-3966

Email Address:

[email protected]

MARKET DATA

1. Number of years as EHR vendor

Practice Partner, Inc. was originally founded as Physician Micro Systems, Inc. in 1983. In its 24-year history, the company provided consistent leadership in the practice management and electronic medical records industry. It’s first software products—scheduling and practice management applications—were installed in 1985, with the industry-leading Patient Records EMR product first released in 1987.

The Practice Partner solution encompasses a complete set of clinical and administrative tools designed to enhance all aspects of the modern medical office. The applications are used

nationwide by practices of all sizes and specialties, from solo practitioner offices to large, enterprise multi-site clinics.

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In February 2007, Practice Partner was acquired by McKesson Corporation, a healthcare services and information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining

processes, and improving the quality and safety of patient care.

In 2008 Medisoft Clinical and Lytec MD were introduced as integrated PM/EHR applications leveraging the Practice Partner EHR and the existing Practice Management applications. This was done to minimize the practice disruption and cost of introducing the EHR by allowing the practice to keep using the Practice Management system they have been using for years.

2. Total customer sites live and in

process to go live

a.

Nationally

PM and EHR – 64,774 _{EHR – 2,649}

b.

Connecticut

PM and EHR – 632 _{EHR – 21}

3. Breakdown of sites by number of

providers (Solo, 2-5, 6-9, >10)

Solo EHR – 1,400 2-5 EHR - 926 6-10 EHR - 148 >10 EHR – 175

4. Provide the number of installed sites

by specialty and size

Primary Care (Family, Internal, Pediatric, OB/GYN, GP, Multi specialty) – 1463 practices ~55%

Other Specialties include Cardiology, Chiro, Dermatology, ENT, Endo, Urgent Care,

Nephrology. Neurology, Oncology, Ortho, Podiatry, Urology – 1186 practices ~45%

a.

Provide the names and contact

information for 3 CT reference sites.

High Ridge Family Practice Alan Falkoff, MD 203-322-7070 Danbury Medical Group

Richard Kopf PA-C 203-794-1979 East Granby Family Practice, LLC Dr. Howlett M.D 860-653-0006

5. How Many “De-Installations in last

36 months?

McKesson has been in the business of advancing the health of the healthcare system for more than 35 years. In rare situations, McKesson and customers have mutually agreed to alter performance obligations or even terminate a

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project. The identity of the customer and reasons for the termination are confidential.

6. Please describe your relationship(s)

with other ONC funded REC’s

McKesson has made an investment to create an organization focused on the needs of the RECs across the country. We are currently executing on a number of programs to help the RECs reach their enrollment targets. One of the most impactful is the use of our existing customers and existing Value Added Resellers. McKesson would like to work with eHealthConnecticut to provide access to our over 600 practices using our solutions today. We would work with you to provide REC value information and can put that in the form of a continuous marketing campaign.

One of the most effective activities we have been doing with RECs is local evening education events where we invite our existing customers to learn about the services the RECs provide. We have executed these events with TN, OK and have planned events with UT and NV. We are also working with other RECs on their events such as with IA, NE.

7. Additional Comments on Market

Data Questions

McKesson has a unique position with the over 100,000 providers using our Practice Management systems across the country. The average practice size is under 2 providers, and we have learned that practices of this size tend to want local service providers that they can build more intimate relationships with that are more affordable and more flexible. It is because of this desire that we make use of over 200 Value Added Resellers across the country to sell, service and support these practices. For additional information, please see our responses to the “Other Issues” section of this document.

PRODUCT INFORMATION

1. Product name and version #

Practice Partner 9.4, Medisoft Clinical V16, Lytec _{MD 2010.}

2. When is your next version release?

Practice Partner Release 9.4 went GA on March 8, 2010. Medisoft Clinical and Lytec MD are based upon the latest release version of Practice Partner. The next release of Practice Partner will be our ARRA release.

3. Is your product a Client Server, ASP

or Hosted model? Describe each

offering.

Practice Partner Offers both a Client Server and an ASP model.

As a Client-Server model, customers install and support their own servers and can make the

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application available over the internet using either Citrix or Terminal Server. One server may be utilized to manage all aspects of the application, or, separate servers may be implemented, such as Application server, Data Base server, fax servers, image servers, for example.

The Practice Partner ASP is simply another way of accessing and utilizing Practice Partner

applications. Instead of installing the software on a dedicated server at the customer site, the software is installed and maintained at the Practice Partner data center in our Seattle office.

4. Are Clinical Components

Integrated?

The Practice Partner product line is a complete set of fully integrated clinical tools designed to help the modern medical office operate efficiently, and improve quality of care.

a.

If yes, list integrated components

(e.g. e-prescribing, lab, etc)

The integrated components are Patient Records, a leading electronic health records system; Billing, a complete practice financial system; Scheduling, a fast and flexible master scheduler; Order Entry, a comprehensive yet easy-to-use computerized physician order entry system and SureScripts Electronic Prescribing Network Service.

b.

If no, list non-integrated components

N/A

5. Are Practice Management

components integrated?

Yes, Practice Partner Practice Management is a complete set of fully integrated administrative tools.

a.

If yes, list all components.

The integrated components are Medical Billing, a comprehensive practice management system; Appointment Scheduler, a sophisticated multi-clinic scheduler; and Zoom our new document

management system.

b.

If no, list non-integrated components

N/A

6. Do you offer a Revenue Cycle

Management or Billing Service for

your clients?

Yes, Practice Partner offers Revenue Cycle management through several different options.

a.

If yes, please describe

McKesson provides a number of revenue cycle management and outsourced billing options. The first is through our McKesson Revenue

Management Services (RMS). This organization outsources billing and collections for practices of all size and specialty. We all have outsourced billing through our Value Added Resellers. The Value Added Resellers provide customized billing and collection options that can be tailored in numerous

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pricing models with the convenience and

confidence of local support. McKesson provides a number of revenue cycle management and outsourced billing options. The first is through our McKesson Revenue Management Services (RMS). This organization outsources billing and collections for practices of all size and specialty. We have also outsourced billing through our Value Added Resellers. The Value Added Resellers provide customize billing and collection options that can be tailored in numerous pricing models with the convenience and confidence of local support.

7. Describe your patient portal

offerings and plans, if any.

McKesson offers Practice Partner Web View, a patient portal that connects providers with patients and outside healthcare personnel. Using Web View, patients and external providers can logon to view patient chart information such as lab results, progress notes, medications, problems, and more.

CERTIFICATION

1. Is the product CCHIT certified?

Yes. It should also be noted that based on

recommendations adopted by the Health IT Policy Committee on July 16 2009, certification of EHRs will be matched more closely to meaningful use criteria under the HITECH provision of the

American Recovery and Reinvestment Act of 2009 (ARRA). The certification will be referred to as “HHS certification,” and it will include requirements for security, privacy and interoperability. HHS certification will focus on meeting the functional requirements of the ARRA statute to achieve meaningful use. McKesson is committed to providing solutions that meet the required HHS certification levels necessary for hospital and physician participation in various incentive and legislative programs. Current certification status of McKesson solutions is as follows:

2. Version, Year and Type

(Comprehensive or Modular) of

CCHIT Certification

McKesson’s Practice Partner solution is certified under the CCHIT Ambulatory Certification program. Practice Partner Releases 9.2.1 and 9.2.2 are both ambulatory CCHIT 2007 certified. Release 9.3 is CCHIT 2008 certified. Medisoft Clinical and Lytec MD are both CCHIT 2008 certified.

Comprehensive.

3. List any other current or planned

Certifications

McKesson has evaluated our product capabilities and release levels to help support our customers in their efforts to demonstrate meaningful use of EHR technology. Most of the meaningful use criteria outlined for 2011 – with the exception of those in the areas of reporting and interoperability– are

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either already met by the current releases of all our electronic health record (EHR) solutions or require only minor enhancements.

We built our product roadmaps around what we believed would be included in the requirements and have continuously reviewed and adjusted our roadmap based upon the latest requirement information available. We are diligently working to enhance or further develop our EHR solutions to meet the certification criteria for meaningful use of EHR technology.

MEANINGFUL USE

1. Do you offer a “Meaningful Use”

Guarantee?

Yes, when requested by a customer, McKesson will agree that its Practice Partner, Medisoft Clinical, and Lytec MD will meet the applicable Stage 1 certification criteria established by the ONC for HIT for purposes of determining whether an eligible professional is a meaningful user of certified EHR technology (as defined under ARRA) by January 1, 2011; and if not, we will offer a credit of one month of maintenance fees for each month that the applicable software does not meet the certification criteria (up to a maximum of 12 months) to affected customers who are current in their payment of maintenance fees.

a.

If yes, describe the level of financial risk you

will share with provider customers.

Please refer to the response provided above.

2. Describe your plans and timelines to become

“Meaningful Use” Certified by ONC?

McKesson has evaluated our product capabilities and release levels to help support our customers in their efforts to demonstrate meaningful use of EHR technology. Most of the meaningful use criteria outlined for 2011 – with the exception of those in the areas of reporting and interoperability– are either already met by the current releases of all our electronic health record (EHR) solutions or require only minor enhancements.

We built our product roadmaps around what we believed would be included in the requirements and have continuously reviewed and adjusted our roadmap based upon the latest requirement information available. We are diligently working to enhance or further develop our EHR solutions to meet the certification criteria for meaningful use of EHR technology.

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HEALTH INFORMATION EXCHANGE (HIE)

1. Describe your HIE capabilities and

experience with HIE implementations.

Practice Partner currently works with a number of HIE solutions across the country, and supports local information exchange requirements. We have some of the most advanced integration with industry leaders such as RelayHealth HIE, Axolotl,and Medicity. This HIE integration experience gives us the know-how to not only create the HIE connectivity, but to do so in a way that provides the ideal value to the providers using the exchange. McKesson would be happy to help our customers collaborate with an HIE, and assist them with compliance with information exchange requirements and associated security and privacy guidelines.

2. What HIE connections and interfaces if any

are included with your product.

There is service time associated with setting up and training providers to use HIE connectivity. This will vary based upon the connectivity type.

McKesson will work with eHealthConnecticut to establish a reasonable price or package for our providers.

eHealthConnecticut HIE technical specifications are found on the eHealthConnecticut

website at

After reviewing, please comment on your ability to commit to meeting these requirements

and in what timeframes. Please be sure to include specific responses regarding patient

registration and query (PIX/PDQ) transactions, XDS transactions including Continuity of

Care Documents, and BPPC:

Practice Partner currently works with a number of HIE solutions across the country, and supports local information exchange requirements. We have advanced integration with RelayHealth HIE

Practice Partner supports the capability to export patient summary information in a CCD (Continuity of Care Document) format, which is the industry’s de-facto standard for Health Information Exchange. Practice Partner users have the ability to create a CCD with specific information/reports/ from the patient chart, considering the relevance of the exchange to patient care and balancing the need for exchanging such information with the patient’s interest/consent for disclosure of such information. It is planned with a future release that Practice Partner will be compliant with external HIE systems that implement the XDS IHE repository profile, which enables standardized exchange of patient clinical summaries. Future releases will also include Patient Data Link (PDL), a web-service based set of APIs that enable external systems to query patient summaries (compliant to the CCD standard) from Practice Partner. Practice Partner includes PDQ capabilities and we are currently in process with our PIX support. Practice Partner does not support any integration with GoogleHealth, or HealthVault. We do support communication with PHR’s that can accept CCD or CCR’s via file, and CCD’s via HIE repository or PDL.

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Pricing and Related Services

1. Are you willing to have us publish your

pricing on our website?

Yes

2. Describe your software pricing in detail,

including all components for which a practice

may be charged.

Please refer to the pricing matrix for Practice Partner, Medisoft Clinical and Lytec MD included as part of this proposal.

3. Are you able to offer a discount for

customers of the eHealthConnecticut REC?

Yes.

a.

If yes, please describe

McKesson is willing to work with

eHealthConnecticut to provide an ideal value for eHealthConnecticut REC customers. This can be as simple as a software discount for participating with eHealthConnecticut, but additional alternatives are available based upon the desire to take

advantage of other McKesson Physician Office solutions. These options include EDI transactions via McKesson owned RelayHealth, HIE

connectivity and medical office supplies.

4. Do you bundle or arrange for any other

related services such as hardware, network, and

ISP purchasing and support?

Yes.

a.

If yes, please describe all such relationships

and services

We have a number of options to bundle these services in a single solution. The first option is our preferred partnership with HP. This partnership gives bundled assessments, hardware, support and other services such as networking at a premium price. We also have a network of local Value Added Resellers that will custom tailor these packages.

IMPLEMENTATION TRAINING AND SUPPORT

1. Briefly describe your Implementation Plan.

Address issues such as on-site versus website

training, workflow analysis, existing data

conversion, who is trained, and software and

template customization

Please refer to the sample High Level

Implementation Plan included in the attachments. McKesson and its VAR partners offer a full life cycle service model:

-Initial consulting on IT infrastructure -Setup of infrastructure

-Consulting and training of the McKesson solutions -Ongoing support and maintenance (software updates)

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-Post live optimization services -Customized post-live consulting

McKesson implements our EHR solutions through a structured series of sessions. In all cases, a set of starter data is included to help the practice get a fast start with the product. First, the practice is taught how to configure and maintain the system, and also how to customize the included clinical documentation templates to meet their workflow needs. Then, the end user training is delivered. End user training can be done either remotely on onsite. This will depend on the package that is purchased by the practice. All activities are centered on enabling the practice to meet

meaningful use criteria. Modules like e-Prescribing, order entry, and eligibility checking are all part of the go live process if purchased.

2. Provide the normal length of

implementation by practice size (solo, 2-5, 6-9,

>10)

Typically, the size of the practice does not impact the length of the implementation process.

Please refer to the sample High Level

Implementation Plan included in the attachments. Standard implementation time is 90-120 days for complete configuration, implementation, training, and go-live.

3. Describe your ongoing support post

implementation.

Regular Practice Partner Technical Support hours are Monday through Friday from 5:00 a.m.–5:00 p.m. PST (coinciding with 7 a.m. to 7 p.m. Central time). After hours software support is available to customers who have a 24 x 7 support contract. Customers can also choose to access 24 x7 support by providing a credit card number and paying an hourly rate for case-by-case incidences. Customers with a Technical Support contract may contact Technical Support via phone, e-mail, Customer Support Web Site, or fax. Technical Support uses a sophisticated remote diagnostics tool to access your system for troubleshooting. All that is required is an Internet connection.

Customers may review the status of outstanding problems on the customer support website. Enhancements can be viewed on the customer support website and can be downloaded as well. Quarterly Updates for our Clinical Tools and Formularies are also available. We also have launched a support survey for customers to complete after receiving support from our support department.

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4. Describe your training and support pricing

structure.

In the attached Pricing Matrix you will see the breakdown for our McKesson Direct

Implementation services, which include training and support. Implementation can be provided directly from McKesson or via a Value Added Reseller, and the Value Added Reseller Pricing can be different based upon the type of local service a customer wants bundled.

Our general approach with implementation services and training is based on the total number of hours times a rate per hour. This does change based upon the use of onsite resources versus remote resources.

Support and maintenance pricing is based upon a percentage of the software total for Practice Partner and fixed fee per provider loosely based upon the Practice Partner maintenance fees. Please refer to the Pricing matrix included with this proposal for more details.

OTHER ISSUES

1. Do you utilize other companies or

services in the process of bringing a process

through the implementation and go live

process?

Yes. We offer implementation services and ongoing support directly from McKesson as well as indirectly through our Value Added Resellers. We manage a network of over 200 Value Added Resellers that provide flexibility and exceptional value for local service and support for small practices.

2. What is your current “wait time” to begin

an installation in Connecticut?

Some local Value Added Resellers can begin immediately. Directly through McKesson we are about 6-8 weeks out.

3. Are you willing to help sponsor eHealthCT

REC promotional activities and conferences?

Yes

a.

If yes, describe

McKesson is interested in working with

eHealthConnecicut on any number of promotional activities including, but not limited to, participation in eHealthConnecticut events, local McKesson Events, Local Tradeshows such as MGMA, ride along efforts with our local sales representatives, Web-based co-marketing, promotions, direct mail, and telemarketing.

4. Any other information you would like to

provide?

McKesson, is a large, diverse, and resource rich organization. We are prepared to engage with eHealthConnecticut in a number of unique ways

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outlined below. We are also willing to work with eHealthConnecticut in an open and flexible manner focused on the Providers and their Patients. 1.Dedicated Resources for RECs and eHealthConnecticut REC

a. Governance and Relationship Management McKesson has established a dedicated team focused on the REC effort. This team will help establish a single relationship manager at the executive level for governance, project oversight and continuous improvement purposes. We have for decades managed large, complex Health Care IT engagements with the highest level of personal attention. We will leverage this high touch model for our REC engagements.

b. REC Education and Certification

McKesson has established a number of education and certification programs for our Value Added Reseller Partners and end users. These programs can be leveraged by the REC in their current fashion, or custom programs can be put together. We are currently developing a custom approach to REC education that focuses on speed and quality of data input and retrieval. With this focus the RECs can get the critical application information needed without spending days in the classroom. c. Local Sales, Service and Support

McKesson has over 100,000 Providers using our Practice Management and EHR solutions. The overwhelming majority of the providers are in the small practice (1-2 providers) space. We have been able to sell, service and support these providers through our local presence. We believe that local presence is critical to the initial and continued success of these small practices. They generally lack the IT infrastructure, knowledge or time to spend on these types of projects. Therefore they look to local, affordable, trouble-free solutions. McKesson uses a network of over 200 Value Added Resellers to provide this High Value set of solutions and services. These Value Added Resellers live and work in the communities in which they support. They also offer flexibility, innovation and a breadth of services beyond a classic EHR software vendor. Everything from networking, bill services, telecom setup, custom develop and practice consulting are available through our Value Added R0esellers.

One or more of our Value Added Resellers could be partnered with eHealthConnecticut to ensure the local, consistent presence focused on your success is being delivered.

d. Successful Execution of Similar Models McKesson has worked within our existing install

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base of hundreds of hospitals to develop McKesson Physician Alliance Programs. These programs enable hospitals to engage their affiliated physicians with the use of our EHR solutions, our connectivity solutions and our Value Added Reseller network. We will engage a hospital to help build a strategy that often involves the hospital outsourcing the sales, marketing, implementation and support of the solution to McKesson and our Value Added Resellers. This approach has been met with wild success as it allows the hospital to focus on their core competencies, while McKesson helps them improve the capability of the practice and connect their community. One example is our relationship with Eisenhower Medical Center in Palm Springs, CA. Within 9 months of the

program’s start, 30% of the affiliated practices had agreed to use our Practice Partner, Medisoft Clinical or Lytec MD EHR.

2. Leverage of Existing Install Base a. Medisoft/Lytec Practice Management

McKesson’s install base of practice management customers is vast in small, primary care practices. We have over 600 Practices in Connecticut. We have been working with a number of RECs to help provide access to these practices with various methods. For our existing Medisoft and Lytec Practice Management customers we offer an easy and affordable upgrade path to EHR. This upgrade path solution is referred to as Medisoft Clinical and Lytec MD. These certified, combined PM/EHR solutions leverage the certified Practice Partner EHR and existing Practice Management system. b. Existing Hospital Relationships

McKesson has hospital relationships in

Connecticut. These hospital relationships can also be leveraged to help meet provider targets and help connect the CT practices.

c. Existing EHR

McKesson’s install base of practice management and hospital customers is also complimented with approximated 10,000 existing EHR providers nationwide. These practices will be looking to McKesson and the RECs for help in getting to meaningful use. A strong partnership would include bringing these existing customers to eHealthConnecticut.

3. Leverage of Health Care Diversity

McKesson as the largest and oldest Health Care Company in the U.S. serves small primary care providers in a number of other ways. Below you will see some potential areas where a relationship with eHealthConnecticut and McKesson may

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provide additional value to providers and the mission of both eHealthConnecticut and McKesson.

a. EDI

McKesson owns one of the largest EDI clearing house solutions in the U.S. Through RelayHealth we process 1.8B financial transactions across with a combined value of over $1Trillion in billed charges. These transactions include Claims, Remittances, Eligibility, Authorization and Claim status. Leveraging this capability may be an opportunity to add value to both the practice and eHealthConnecticut sustainability model. b. Medical/Surgical Supplies

McKesson has over 500 Medical/Surgical representatives working with 40,000 practices predominantly in small primary care offices across the U.S. These representatives service practice needs for everything from consumable practice supplies to a full lab setup, to Practice

Management and EHR Software and services. Leveraging this capability may be an opportunity to add value to both the practice and

eHealthConnecticut sustainability model. c. Quality Tools and Consulting

McKesson Health Solutions (MHS) is one of the largest software and service providers for Payors. With solutions like InterQual, A product used by 41 QIOS, and the MHS Disease Management

services, McKesson has extensive experience in health quality management. Leveraging this capability may be an opportunity to add value to both the practice and eHealthConnecticut sustainability model.

4. McKesson EHR and Connectivity Solutions a. Bright Note Technology – Fast and Easy Practice Partner, Medisoft Clinical and Lytec MD make use of Bright Note Technology. This tool is built into the EHR Solutions to allow providers to quickly enter data the way they are accustomed, while getting the benefits of discrete data recording. As the provider creates the note, heavy “click” drop down menus and other templates are not required and the system is intelligent enough to extract the data and store in the appropriate discrete data fields.

b. HIE Connectivity

Practice Partner, Medisoft Clinical and Lytec MD boast have the most advanced connectivity with many HIE vendors and systems. This connectivity allows our providers a high level of integration which can improve ease of accessing HIE information.

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PPRNET is an anonamized Clinical Data Repository focused on improving the quality of care. Providers are giving by producing quality reporting and benchmarking these reports against the total population and peers.

5. Additional Reasons to Partner with McKesson We have attached in the executive summary our top reasons for Partnering with McKesson. Our size and reach balanced with our intimate approach for the small practice give us a very unique model for doing business.

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Pr

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Pricing Matrix

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eHealthConnecticut McKesson

1 Provider 5 Providers 10 Providers ASP per Provider

EHR Software

Practice Partner EHR $5,198 Medisoft Clinical $3,405 Lytec MD $3,800

Practice Partner $ 27,256 Medisoft Clinical $17,025 Lytec MD $21,500

Total Practice Partner $ 45,695 Medisoft Clinical $34,050

Lytec MD $40,500 Practice Partner EHR $400/month

Add PM Practice Partner PM $4,252 Medisoft Clinical PM $2,075 Lytec MD PM $2,500 Practice Partner PM $ 21,260 Medisoft Clinical PM $ 3.464 Lytec MD PM $ 2,500 Practice Partner PM $ 42,520 Medisoft Clinical PM $ 4,164

Lytec MD PM $2,500 Add Practice Partner PM $100/Month Core Implementaion and Training

Total Practice Partner $12,229 Medisoft Clinical $4,375 Lytec MD $4,375

eRX per Year $240 $1,200 $2,400 $240

Clinical Tools per Year $350 $1,750 $3,500 $350

Adv Pat Ed. per Year $175 $875 $1,750 $175

Code Updates per Year $50 $250 $500 $50

Prodiver/Patient Portal & Secure Messaging $300 per year $300 per year $300 per year $300 per year

Report Tools $495 $495 $495 $495

Scanning Included Included Included Included

Faxing $0 $883 $883 $0

Voice Recognition $995 per user $995 per user $995 per user $995 per user

EDI $90 per month - Includes unlimited claims, ERA and eligibility $450 per month - Includes unlimited claims, ERA and eligibility $900 per month - Includes unlimited claims, ERA and eligibility $90 per month - Includes unlimited claims, ERA and eligibility

PM/EHR Maintenance and Support - Year 1

Total Practice Partner Software Maintenance and Support - Included Medisoft Clinical Software Maintenance and Support - $1500 Lytec MD Software Maintenance and Support - $1500

Total Practice Partner Software Maintenance and Support - Included Medisoft Clinical Software Maintenance and Support - $7500 Lytec MD Software Maintenance and Support - $7500

Total Practice Partner Software Maintenance and Support - Included Medisoft Clinical Software Maintenance and Support - $15000 Lytec MD Software Maintenance and Support - $15000 Included

PM/ EHR Maintenance and Support - Year 2+

Total Practice Partner Software Maintenance and Support - $1795 Medisoft Clinical Software Maintenance and Support - $1500 Lytec MD Software Maintenance and Support - $1500

Total Practice Partner Software Maintenance and Support - $8975 Medisoft Clinical Software Maintenance and Support - $7500 Lytec MD Software Maintenance and Support - $7500

Total Practice Partner Software Maintenance and Support - $17950 Medisoft Clinical Software Maintenance and Support - $15000 Lytec MD Software Maintenance and Support - $15000 Included

Data Conv

No charge for certain conversions. Custom quoted based upon source system and data elements

Interfaces

Standard lab interfaces are between $2500 and $3500 and often paid for by the lab. Custom Interfaces quoted at $175/hour.

Server HW $3,200 $3,200 $9,625 $0

Client HW $4,000 $20,000 $35,000 $4,000

Other HW - Scanner, Neworking $1,100 $1,100 $2,200 $1,100

Internet Access $600 $1,200 $1,200 $2,400

All prices and packages are best estiamtes and subject to change at any time without notice

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At

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Attachments

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Samp

le

Imp

le

me

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io

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Plan

Attachment A.

Sample Implementation Plan

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Timeline (Assumes Contract

signed/HW ordered) Visit purpose Resources

Onsite or

Remote Tasks

Assess and Design Phase

Week 1 Kickoff /Application Training PM, IC, Client Project

Team

Onsite Day 1 Kickoff/Walk through/Demo Day 2 Application Training Day 2 Application Training Day 3

Workflow discussions, review current

state workflow Week 1 Techical System Overview TE, Client Project Team Remote Technical Engineer

Week 2 Build Preparation Client Project Team Customer completes data gathering

form Build Phase

Week 4 Template design IC, Client Project Team Remote Template Design discussion

Week 5 Configuration Training

Patient Records Templates,

ePrescribing, Future Workflow

IC, Client Project Team Onsite Day 1 Admin/PR/OE

Day 2 Admin/PR/OE

Day 3 ePrescribing Day 3

Template build Week 6 Client Project Team Application Build

Week 7 Build Check IC, Client Project Team Remote Follow‐up on config build / customer

build

Week 8 Client Project Team Application Build

Week 9 Build Check Testing

Prep/ePrescribing Config/Back

Loading Prep

IC, Client Project Team Onsite Day 1 Build Check Day 2

Review Test Plans Day 2 Review

Training Plan Day 3 ePrescribing

config

Week 10 Client Project Team Application Build Week 11 Client Project Team Application Build

Week 12 Config/ Build validation IC, Client Project Team Remote conf call to validate and signoff on

config

Week 13 End‐User Training Preparation IC, Client Project Team Remote review end user documentation and

prep them to do EUT prep them to do EUT Test phase

Week 14 System Testing IC, TE, Client Project

Team, Optional Super‐

User

Remote integration, interface, functional, See

Test Approach.doc Training Phase

Week 15 End‐User Training Preparation/

Back Loading Begins

Client Project Team Client begins with go‐live week and

then continue with a rolling two

window scedule

Week 16 End user Training Total

Practice Partner

IC, Client Project Team Onsite End User training‐pilot site Role based

Week 17 Contiune Backloading Client Project Team continue with a rolling two window of

the scedule Go‐live Phase

Week 18 Go Live IC, PM, Client Project

Team, TE ‐ Remote

Onsite Go Live Support Post Live / Transition to

Support Phase

Week 19

Week 20 2 Week Follow‐up Visit IC, Client Project Team Onsite Enhance workflow Week 22 4 Week follow‐up Remote Enhance workflow Week 24 6 Week follow‐up IC, Client Project Team Onsite Enhance workflow Week 27 8 Week follow‐up IC, Client Project Team Onsite Transition to support

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Sy

ste

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Re

qu

ire

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Attachment B.

System Requirements

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Practice Partner 9.4

McKesson Provider Technologies

Practice Partner

2401 Fourth Avenue, Suite 700 Seattle, WA 98121

1.800.770.7674

www.practicepartner.com

P

RACTICE

P

ARTNER

®

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06-03-2010

This publication, or any part thereof, may not be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, storage in an information retrieval system, or otherwise, without the prior written permission of McKesson Information Solutions LLC.

The information in this guide has been carefully checked and is believed to be accurate. McKesson assumes no responsibility for any inaccuracies, errors, or omissions in this guide.

McKesson reserves the right to revise this publication and to change its content without obligation to notify any person of the revision or changes.

Microsoft and Windows are registered trademarks of Microsoft Corporation. Other brands and their products may be registered or unregistered trademarks of their respective owners.

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Practice Partner 9.4 System Requirements

Glossary

Thin Client Workstation

A thin client workstation refers to a device whose purpose is to connect to a thin client server. This can be a workstation, tablet or a purpose-built thin client device such as a Wyse Terminal. The Practice Partner application software is installed on a thin client server. Information that passes across the network from the end-user is keystrokes, mouse movements, and screen images.

Application Server

All customers will have an application server. This server is where the Practice Partner application folder resides. The Practice Partner network services are also installed on this server. For customers using the c-tree Server database type, this is where your database files will reside.

Database Server

Customers running Oracle or SQL for their database type will also have a database server. This server runs the RDBMS software and is where the majority of the patient data will be stored. This is in addition to an application server, as the application server will still be required to house the application folder.

Thin Client Server

A thin client server is a shared resource that runs applications, as opposed to having the software installed locally on PCs. It provides advantages in ease of management and potentially cost savings in software licenses and client hardware. For large organizations, there may be several thin client servers in the network. Thin client servers can use Terminal Services by itself or also run the Citrix software. Use of Terminal Servers and/or Citrix is referred to as thin client server technology. Thin client servers are used when users are connecting from remote locations (through a WAN or broadband) or through a wireless connection. Thin client servers can also be used on a LAN to simplify administration. Please make note of the thin client server limitations at the end of this document.

Standard Workstation

A standard workstation may also be referred to as a fat client, or thick client. The Practice Partner software is installed on the computer itself. Standard Workstations must be on a LAN to the database server (and application server, if applicable).

Application Folder

Every Practice Partner installation has an application folder. This folder contains (but is not limited to): configuration files, client software installation files, interface files, temporary files, and unless

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Recommended Configurations

Below are the McKesson Practice Partner infrastructure recommendations. These recommendations are based on a mix of industry standard technologies and proven experience of our customers. These recommendations are also based on the minimum requirements listed in this document. Adding additional resources to some equipment may change the recommended configuration.

These recommendations are for production environments only. Additional infrastructure requirements may be necessary for reporting, failover, testing or training environments.

Please note that recommendations are based on a maximum of 5 concurrent Practice Partner sessions per provider. For customers with multiple databases, the number of providers is calculated per database instance.

Also note that these requirements are specific to Practice Partner 9.4. Although we try to anticipate future hardware and software needs and compatibilities, recommended/required configurations may change with future versions so please be sure to consult the documentation appropriate to the version you are installing or upgrading to.

1-10 Providers (c-tree Server)

• An application server is required.

• Thin client server technology is required for users connecting remotely (from home, over a WAN, through a VPN, etc.) or through wireless devices.

• A separate thin client server is required if the total number of thin client users exceeds 10.

10-15 Providers (c-tree Server, Microsoft SQL 2005, or

Microsoft SQL 2008)

• A database server is required for Microsoft SQL.

15-20 Providers (Microsoft SQL 2005, Microsoft SQL 2008,

or Oracle 11g Standard One)

• A database server is required.

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20+ Providers (Oracle 11g Standard One)

• A database server is required.

Optional Servers

Interface Workstation/Server

Customers will often have interfaces to external systems, such as laboratories. Depending on the configuration of the customer and the number of interfaces that will be run, an interface workstation or server may be recommended.

Fax Server

For smaller customers, the fax board may be installed on one of the existing servers in the

environment, typically the application server. For larger customers doing significant volume of faxing, a separate fax server may be required. This server cannot be virtualized.

Web View Server

If you are using the Web View product, you must also have a separate server to run the web services. This must be its own server and cannot have patient data on it as the server must be configured to reside in the network’s DMZ or have an encrypted tunnel to the internet to facilitate web traffic.

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Supported Operating Systems

• Small Business Server products are not supported

• For database servers and thin client servers, 64-bit operating systems are strongly recommended due to the ability to use additional RAM

• Any operating system not listed should be considered not supported

• Unless otherwise specified, 32 and 64 bit server operating systems are supported

• Home operating systems are not supported

Application Server

• Windows Server 2003 R2

• Windows Server 2008

• Windows Server 2008 R2 is not supported

Database Server

• UNIX (Oracle database only)

Thin Client Server

• RemoteApp feature is not supported

• Citrix MetaFrame 4.5

Web View Server

Interface Workstation

• Windows XP Professional

• Windows Vista Business

Interface Server

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Fax Server

Standard Workstation/Laptop/Tablet

• Windows XP Professional

• Windows Vista Business

• Windows XP Tablet Edition

Thin Client Workstation/Laptop/Tablet

Since thin client workstations, laptops and tablets do not run any Practice Partner software, any operating system capable of running the appropriate thin client software is acceptable.

Some thin client devices come with a limited amount of on-device storage. Practice Partner has not been tested to run in this configuration and there will very likely be problems. Thin client devices that will be accessing Practice Partner must do so through a thin client server.

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Third-Party Software Compatibility

McKesson Practice Partner sells several third-party software solutions that integrate with the Practice Partner software. Customers may already own this software or can purchase it through other vendors. To ensure proper operation, below is a list of the specific software versions that are compatible with 9.4.

• Dragon Naturally Speaking 9.5 and 10.0

• ZetaFax 2009

• Midmark ECG 8.1

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Hardware Requirements

The hardware requirements listed below are designed to allow customers flexibility in their

deployment of Practice Partner. For specific formulas in determining how much hard drive space you need, please see the “Disk Storage Requirements” section.

The below requirements are for the Practice Partner software only. If you decide to run additional services (for example, DNS or Active Directory on your application server, or Microsoft Office on your thin client server) you will need to add additional CPUs and/or RAM.

Application Server

Component Minimum Requirement

CPU (Processor) Intel Dual Core Xeon 2.0GHz RAM (Memory) 4GB

Storage Array Type RAID-5 or SAN Optical Drive DVD-ROM Network Card (NIC) 1Gbps

For smaller customers, the above specifications will support up to 10 thin client users and the Practice Partner application folder.

Database Server (SQL or Oracle)

CPU (Processor) Dual Intel Quad Core Xeon 2.0GHz

RAM (Memory) 8GB (16GB for 300-1000 users, 32GB for 1000+ users) Storage Array Type RAID-1 and RAID-10 or SAN

Optical Drive DVD-ROM Network Card (NIC) 1Gbps

Oracle and SQL servers require multiple RAID arrays. One array is for the database files, the other is for either transaction logs (SQL) or archive logs/redo logs (Oracle). A third array is recommended for the operating system.

Sample database server (less than 300 users)

• 2 x Quad Core Intel Xeon 2.5GHz

• 8GB RAM

• 2 x 73GB SAS RAID-1 (Operating System and Logs)

• 2 x 146GB SAS RAID-1 (Logs and Pagefile)

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Thin Client Server

Thin client servers are designed to support 25 sessions of Practice Partner only. For each additional 25 sessions of Practice Partner, add 4GB of RAM and 2 more CPU cores.

Web View Server

CPU (Processor) Intel Dual Core 2.0GHz RAM (Memory) 2GB

Thin Client Workstation/Laptop/Tablet

CPU (Processor) Intel Dual Core 1.6GHz (1.0 for Tablets) RAM (Memory) 2GB

Network Card (NIC) 100Mbps (or 802.11g for wireless)

Video Resolution 1024x768 (1200x800 for widescreen displays)

Interface Computers

Interface Workstation

CPU (Processor) Intel Core 2 Duo 2.0GHz

RAM (Memory) 2GB for Windows XP, 4GB for Windows Vista Optical Drive DVD-ROM

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Interface Server

Interface servers are necessary when running over 10 total interfaces. Additional CPUs or RAM are necessary for more interfaces to be run.

• For up to 9 interfaces, use an interface workstation

• For 10+ interfaces, use an interface server

Standard Workstation/Laptop (Fat Client Configuration)

CPU (Processor) Intel Core 2 Duo 1.6GHz

RAM (Memory) 2GB for Windows XP, 4GB for Windows Vista Network Card (NIC) 100 Mbps

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